Ciprofloxacin (Intravenous route)

Pronunciation:

sip-roe-FLOX-a-sin

Brand Names:

Cipro IV

Ciprofloxacin

Cipro Iv Minibags

Dosage Forms:

Solution

Warnings:

Intravenous route(Solution)

Fluoroquinolones, including ciprofloxacin, are associated with disabling and potentially irreversible serious adverse reactions that have occurred together, including tendinitis and tendon rupture, peripheral neuropathy, and CNS effects. Discontinue ciprofloxacin and avoid use of fluoroquinolones in patients with these serious adverse reactions. Reserve use of ciprofloxacin for patients with no alternative treatment options for an acute exacerbation of chronic bronchitis or acute sinusitis. Fluoroquinolones, including ciprofloxacin, may exacerbate muscle weakness in persons with myasthenia gravis. Avoid in patients with known history of myasthenia gravis .

Classifications:

Therapeutic—

Antibiotic

Chemical—

Fluoroquinolone

Uses of This Medicine:

Ciprofloxacin injection is used to treat bacterial infections in many different parts of the body. It is also used to treat anthrax infection after inhalational exposure. This medicine is also used to treat and prevent plague (including pneumonic and septicemic plague).

Ciprofloxacin belongs to the class of drugs known as quinolone antibiotics. It works by killing bacteria or preventing their growth. However, this medicine will not work for colds, flu, or other virus infections.

This medicine is to be given only by or under the direct supervision of your doctor.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of ciprofloxacin injection in children. However, because of this medicine's toxicity, it should be used with caution, after other alternatives have been considered and/or found ineffective. Ciprofloxacin injection may be used in children to prevent anthrax infection after possible exposure, and to treat serious kidney infections.

Older adults—

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of ciprofloxacin injection in the elderly. However, elderly patients are more likely to have age-related heart or kidney problems, or develop severe tendon problems (including tendon rupture), which may require caution in patients receiving ciprofloxacin injection.

Pregnancy—

Pregnancy Category

Explanation

All Trimesters

C

Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast-feeding—

Ciprofloxacin

Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

Ciprofloxacin Lactate

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Agomelatine

Amifampridine

Amisulpride

Bepridil

Cisapride

Dronedarone

Flibanserin

Mesoridazine

Pimozide

Piperaquine

Saquinavir

Sparfloxacin

Terfenadine

Thioridazine

Tizanidine

Ziprasidone

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Acarbose

Acecainide

Acetohexamide

Alfuzosin

Alogliptin

Alosetron

Amiodarone

Amitriptyline

Amoxapine

Anagrelide

Apomorphine

Aripiprazole

Aripiprazole Lauroxil

Arsenic Trioxide

Artemether

Asenapine

Astemizole

Azimilide

Azithromycin

Bendamustine

Benfluorex

Bosutinib

Bretylium

Buserelin

Canagliflozin

Chlorpromazine

Chlorpropamide

Cholera Vaccine, Live

Cilostazol

Citalopram

Clarithromycin

Clomipramine

Clozapine

Crizotinib

Cyclobenzaprine

Dabrafenib

Dapagliflozin

Dasatinib

Deflazacort

Degarelix

Delamanid

Desipramine

Deslorelin

Deutetrabenazine

Disopyramide

Dofetilide

Dolasetron

Domperidone

Donepezil

Doxorubicin

Doxorubicin Hydrochloride Liposome

Droperidol

Efavirenz

Eliglustat

Eltrombopag

Erlotinib

Erythromycin

Escitalopram

Exenatide

Fingolimod

Flecainide

Fluconazole

Fluoxetine

Foscarnet

Gatifloxacin

Gemifloxacin

Gliclazide

Glimepiride

Glipizide

Gliquidone

Glyburide

Gonadorelin

Goserelin

Granisetron

Halofantrine

Haloperidol

Histrelin

Hydroxychloroquine

Hydroxyzine

Ibrutinib

Ibutilide

Ifosfamide

Iloperidone

Imipramine

Inotuzumab Ozogamicin

Insulin

Insulin Aspart, Recombinant

Insulin Bovine

Insulin Degludec

Insulin Detemir

Insulin Glargine, Recombinant

Insulin Glulisine

Insulin Lispro, Recombinant

Ketoconazole

Lapatinib

Leuprolide

Levofloxacin

Linagliptin

Liraglutide

Lopinavir

Lumefantrine

Lurasidone

Mefloquine

Metformin

Methadone

Metronidazole

Mifepristone

Miglitol

Moricizine

Moxifloxacin

Nafarelin

Naloxegol

Nateglinide

Neratinib

Nilotinib

Norfloxacin

Nortriptyline

Octreotide

Ofloxacin

Olaparib

Ondansetron

Paliperidone

Panobinostat

Pasireotide

Pazopanib

Pimavanserin

Pioglitazone

Pirfenidone

Pitolisant

Pomalidomide

Posaconazole

Pramlintide

Procainamide

Prochlorperazine

Promethazine

Propafenone

Protriptyline

Quetiapine

Quinidine

Quinine

Ranolazine

Rasagiline

Repaglinide

Ribociclib

Rosiglitazone

Salmeterol

Saxagliptin

Sematilide

Sevoflurane

Simeprevir

Simvastatin

Sitagliptin

Sodium Phosphate

Sodium Phosphate, Dibasic

Sodium Phosphate, Monobasic

Solifenacin

Sorafenib

Sotalol

Sulpiride

Sunitinib

Tacrolimus

Tasimelteon

Tedisamil

Telavancin

Telithromycin

Tetrabenazine

Theophylline

Tolazamide

Tolbutamide

Toremifene

Trazodone

Trifluoperazine

Trimipramine

Triptorelin

Vandetanib

Vardenafil

Vemurafenib

Vildagliptin

Vinflunine

Voriconazole

Warfarin

Zolpidem

Zuclopenthixol

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Aceclofenac

Aminolevulinic Acid

Chloroquine

Cyclosporine

Diclofenac

Dutasteride

Fosphenytoin

Itraconazole

Lanthanum Carbonate

Mycophenolate Mofetil

Olanzapine

Phenytoin

Probenecid

Rifapentine

Ropinirole

Ropivacaine

Sildenafil

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

Caffeine

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

Bradycardia (slow heartbeat) or

Diabetes or

Diarrhea or

Heart attack, history of or

Heart disease (eg, heart failure) or

Heart rhythm problems (eg, prolonged QT interval), or family history of or

Hypokalemia (low potassium in the blood), uncorrected or

Hypomagnesemia (low magnesium in the blood), uncorrected or

Liver disease or

Seizures (epilepsy), history of or

Stroke, history of—Use with caution. May make these conditions worse.

Brain disease (eg hardening of the arteries) or

Kidney disease, severe or

Organ transplant (eg, heart, kidney, or lung), history of or

Tendon disorder (eg, rheumatoid arthritis), history of—Use with caution. May cause side effects to become worse.

Myasthenia gravis (severe muscle weakness), or history of—Should not be used in patients with this condition.

Proper Use of This Medicine:

A nurse or other trained health professional will give you or your child this medicine. This medicine is given through a needle placed in one of your veins. This medicine is given slowly, so the needle will remain in place for about an hour.

This medicine comes with a Medication Guide. It is very important that you read and understand this information. Be sure to ask your doctor about anything you do not understand.

Drink extra fluids so you will pass more urine while you are using this medicine. This will keep your kidneys working well and help prevent kidney problems.

Your doctor will give you or your child a few doses of this medicine until your condition improves, and then you may be switched to an oral medicine that works the same way. If you have any concerns about this, talk to your doctor.

Precautions While Using This Medicine:

It is very important that your doctor check your or your child's progress while you are receiving this medicine. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to receive it. Blood and urine tests may be needed to check for unwanted effects.

Do not take tizanidine (Zanaflex®) while you are receiving this medicine. Tell your doctor if you or your child are also using theophylline (Theo-Dur®) or other products that contain caffeine (eg, coffee, soda, chocolate). Using these medicines together may increase risks for more serious side effects.

Ciprofloxacin may rarely cause inflammation (tendinitis) or tearing of a tendon (the cord that attaches muscles to bones). This can occur while you are using the medicine or after you finish using it. The risk of having tendon problems may be increased if you are over 60 years of age, are using steroid medicines (eg, dexamethasone, prednisolone, prednisone, Medrol®), have severe kidney problems, have a history of tendon problems (eg, rheumatoid arthritis), or if you have received an organ transplant (eg, heart, kidney, or lung). Check with your doctor right away if you have sudden pain or swelling in a tendon after exercise (eg, ankle, back of the knee or leg, shoulder, elbow, or wrist), bruise more easily after an injury, or are unable to bear weight or move the affected area. Refrain from exercise until your doctor says otherwise.

Tell your doctor right away if you or your child have any of the following symptoms while using this medicine: convulsions, feeling anxious, confused, or depressed, seeing, hearing, or feeling things that are not there, severe headache, trouble sleeping, or unusual thoughts or behaviors.

This medicine may cause serious allergic reactions, including anaphylaxis, which can be life-threatening and require immediate medical attention. Call your doctor right away if you or your child have a rash, itching, hives, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth after you receive this medicine.

Serious skin reactions can occur with this medicine. Check with your doctor right away if you or your child have blistering, peeling, or loose skin, red skin lesions, severe acne or skin rash, sores or ulcers on the skin, or fever or chills while you are using this medicine.

Check with your doctor right away if you or your child have dark urine, clay-colored stools, abdominal or stomach pain, or yellow eyes or skin. These maybe symptoms of a serious liver problem.

Ciprofloxacin injection may cause diarrhea, and in some cases it can be severe. It may occur 2 months or more after you stop using this medicine. Do not take any medicine to treat diarrhea without first checking with your doctor. Diarrhea medicines may make the diarrhea worse or make it last longer. If you have any questions about this or if mild diarrhea continues or gets worse, check with your doctor.

Tell your doctor right away if you or your child start having numbness, tingling, or burning pain in your hands, arms, legs, or feet. These may be symptoms of a condition called peripheral neuropathy.

Some people who receive ciprofloxacin injection may become more sensitive to sunlight than they are normally. Exposure to sunlight, even for brief periods of time, may cause severe sunburn, or skin rash, redness, itching, or discoloration. When you or your child begin receiving this medicine:

Stay out of direct sunlight, especially between the hours of 10:00 AM and 3:00 PM, if possible.

Wear protective clothing, including a hat and sunglasses.

Apply a sun block product that has a sun protection factor (SPF) of at least 15. Some people may require a product with a higher SPF number, especially if they have a fair complexion. If you have any questions about this, check with your doctor.

Do not use a sunlamp or tanning bed or booth.

If you have a severe reaction from the sun, check with your doctor.

Ciprofloxacin injection may cause some people to become dizzy, lightheaded, drowsy, or less alert than they are normally. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that can be dangerous if you are dizzy or not alert. If these reactions are especially bothersome, check with your doctor.

If you are a diabetic patient taking diabetes medicine by mouth: Ciprofloxacin may cause hypoglycemia (low blood sugar) in some patients. Symptoms of low blood sugar must be treated before they lead to unconsciousness (passing out). Different people may feel different symptoms of low blood sugar. If you or your child experience symptoms of low blood sugar, stop using ciprofloxacin and check with your doctor right away:

puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue

red skin lesions, often with a purple center

red, irritated eyes

severe constipation

severe sunburn

severe vomiting

shakiness in the legs, arms, hands, or feet

small red or purple spots on the skin

sudden shortness of breath or troubled breathing

trouble concentrating

trouble sleeping

unsteadiness, trembling, or other problems with muscle control or coordination

vomiting of blood

yellow eyes and skin

Incidence not known

Bone pain

burning, numbness, tingling, or painful sensations

confusion as to time, place, or person

excessive muscle tone

increased sensitivity to pain or touch

inflammation of the joints

rhythmic movement of muscles

seeing, hearing, or feeling things that are not there

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common

Acid or sour stomach

runny nose

sneezing

Rare

Continuing ringing or buzzing or other unexplained noise in the ears

eye pain

hearing loss

loss of sense of smell

swelling of the breasts or breast soreness in both females and males

white patches in the mouth or on the tongue

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Last Updated: 9/4/2017

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